October 15, 2014
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Second HCW in US has Ebola, reported air travel evening before symptoms

A second health care worker at Texas Presbyterian Hospital has been diagnosed with Ebola. In addition, the worker reported air travel the evening before her symptoms developed, prompting the CDC to reach out to passengers on the flight.

“Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13,” the CDC said in a statement.

CDC Director Thomas Frieden, MD, MPH, said the second HCW traveled to Ohio before the first HCW became ill. At the time of her flight back to Texas, however, she was among the group with known exposure to Ebola and should not have traveled.

Thomas Frieden, MD 

Thomas Frieden

“This patient should not have been allowed to travel by plane or public transport by virtue of being in an exposed group,” Frieden said during a media briefing. “Although she did not report any symptoms or meet the fever threshold of 100.4, she did report that her temperature was 99.5. By both of those criteria, she should not have been on that plane. We will, from this moment forward, ensure that no other individual being monitored for exposure undergoes travel in any way other than controlled movement.”

Frieden said that the level of risk to people around her on the plane is extremely low, but because of the extra margin of safety, the CDC is asking that all 132 passengers call 1-800-CDC-INFO (800-232-4636). The HCW showed no signs or symptoms of illness while on board, according to the flight crew.

“The flight landed in Dallas/Fort Worth at 8:16 pm [Central Standard Time] and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures, which is consistent with CDC guidelines, prior to returning to service the next day,” Frontier Airlines said in a statement. “Frontier Airlines responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may have traveled on flight 1143.”

The HCW had also traveled from Dallas/Fort Worth to Cleveland on Frontier flight 1142 on Oct. 10, according to the statement. Passengers on that flight also should contact the CDC.

Frieden said that the patient is ill, but clinically stable, and will be transferred to Emory University hospital, which cared for the first two American patients diagnosed with Ebola while in Liberia.

The HCW provided care to the index patient, Thomas Eric Duncan, and is the second HCW involved with his care to test positive for Ebola. She reported to the hospital with a low-grade fever on Oct. 14 and was immediately isolated.

Frieden said that both HCW were involved in Duncan’s care while he was suffering severe vomiting and diarrhea. He also said that the CDC is conducting extensive investigations to identify other potentially infected HCWs. Approximately 50 were involved in the Duncan’s care.

The CDC has identified one contact of the first HCW and three contacts of the second HCW who will be monitored, in addition to the 48 contacts of Duncan. None of these individuals have developed symptoms.

Frieden said that the CDC is investigating how the HCWs became infected and said that it may have resulted from variability in procedures observed in putting on and taking off personal protective equipment.